Static and dynamic prognostic factors for hepatitis-B-related acute-on-chronic liver failure
Clinical and Molecular Hepatology
;
: 232-241, 2015.
Artículo
en Inglés
| WPRIM
| ID: wpr-157205
ABSTRACT
BACKGROUND/AIMS:
Hepatitis-B-related acute-on-chronic liver failure has a poor prognosis. However, the advent of potent oral antiviral agents means that some patients can now recover with medical treatment. We aimed to identify the prognostic factors for hepatitis-B-related acute-on-chronic liver failure including the initial as well as the dynamically changing clinical parameters during admission.METHODS:
Sixty-seven patients were retrospectively enrolled from 2003 to 2012 at Samsung Medical Center. The patients were classified into three categories Recovery group (n=23), Liver transplantation group (n=28), and Death group (n=16). The Liver transplantation and Death groups were combined into an Unfavorable prognosis group. We analyzed the prognostic factors including the Model for End-Stage Liver Disease (MELD) scores determined at 3-day intervals.RESULTS:
A multivariable analysis showed that the unfavorable prognostic factors were a high initial MELD score (> or =28) (odds ratio [OR] =6.64, p=0.015), moderate-to-severe ascites at admission (OR=6.71, P=0.012), and the aggravation of hepatic encephalopathy during hospitalization (> or =grade III) (OR=15.41, P=0.013). Compared with the baseline level, significant reductions in the MELD scores were observed on the 7th day after admission in the Recovery group (P=0.016).CONCLUSIONS:
Dynamic changes in clinical parameters during admission are useful prognostic factors for hepatitis-B-related acute-on-chronic liver failure.
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Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Antivirales
/
Pronóstico
/
Vincristina
/
Índice de Severidad de la Enfermedad
/
ADN Viral
/
Prednisona
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Doxorrubicina
/
Oportunidad Relativa
/
Virus de la Hepatitis B
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Clinical and Molecular Hepatology
Año:
2015
Tipo del documento:
Artículo
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